Key K Logan, Rich Christopher, DeCristofaro Claire, Collins Shawn
Nurse Anesthesia Program, Western Carolina University, Candle, NC, USA.
AANA J. 2010 Dec;78(6):468-73.
Emergence agitation (EA) is an important issue in pediatric anesthesia. This phenomenon arises more frequently with the use of inhalational agents. Three commonly used general anesthesia techniques in children were evaluated as to the associated incidence of emergence reactions. An extensive literature review was performed to evaluate these anesthetic practices and the occurrence of EA in young children. Relevant literature was obtained from multiple sources, including professional journals, professional websites, and textbooks. Three categories of anesthesia techniques were reviewed: sevoflurane inhalational general anesthetic, Emerpropofol as an adjunct to sevoflurane general anesthetic, and propofol total intravenous anesthesia (TIVA) techniques. Several variables within each category were evaluated with respect to the outcome of EA: prevention, intraoperative adjuncts, type of surgery, and patient-related factors. According to the literature evidence base, there is an advantage to either propofol TIVA or adjunctive propofol with sevoflurane (compared with sevoflurane alone). We conclude, based on the current evidence, that the use of propofol is associated with a reduction in the incidence of emergence agitation.
苏醒期躁动（EA）是小儿麻醉中的一个重要问题。这种现象在使用吸入性麻醉剂时更频繁出现。对儿童常用的三种全身麻醉技术的苏醒反应相关发生率进行了评估。进行了广泛的文献综述，以评估这些麻醉方法以及幼儿中EA的发生情况。相关文献来自多个来源，包括专业期刊、专业网站和教科书。回顾了三类麻醉技术：七氟醚吸入全身麻醉、依托咪酯作为七氟醚全身麻醉的辅助用药以及丙泊酚全静脉麻醉（TIVA）技术。针对每类技术中的几个变量，就EA的结果进行了评估：预防措施、术中辅助用药、手术类型和患者相关因素。根据文献证据基础，丙泊酚TIVA或丙泊酚与七氟醚联合使用（与单独使用七氟醚相比）具有优势。基于当前证据，我们得出结论，丙泊酚的使用与苏醒期躁动发生率的降低有关。
